Effects of cryoablation and radiofrequency ablation on endothelial and blood clotting activation

Paolo Pieragnoli, Anna Maria Gori, Giuseppe Ricciardi, Gianmarco Carrassa, Luca Checchi, Antonio Michelucci, Raffaella Priora, Anna Paola Cellai, Rossella Marcucci, Luigi Padeletti, Rosanna Abbate

Research output: Contribution to journalArticlepeer-review

Abstract

Cryoablation (CA) emerged as an alternative procedure to radiofrequency (RF). The aim of this study was to compare haemostatic system alterations in patients undergoing RF or CA for atrioventricular nodal reentrant tachycardia ablation. von Willebrand factor (vWF), spontaneous whole blood platelet aggregation, prothrombin fragment F1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT), plasminogen activator inhibitor type-1 (PAI-1), and clot lysis time (CLT) were determined in 48 patients (27 CA; 21 RF; 19M/29F, mean age 49.6 ± 17.6 years). Blood samples were obtained before the procedure (T0), immediately after (T1), and 24 h later (T2). At T1 both procedures were associated with a significant increase in levels of the endothelial activation marker vWF. At T2 vWF levels were lower in CA than in RF group. No changes in whole blood platelet aggregation before and after ablation procedures were observed. At T1 both groups determined an increase in blood clotting activation markers, F1 + 2, TAT, and DD. At T2 F1 + 2, TAT and DD levels were similar to baseline values. The comparison between RF and CA showed no significant differences in F1 + 2 and TAT levels, whereas at T1 DD levels were higher in CA group than in RF group. Both procedures induced a significant decrease in CLT, whereas no changes in PAI-1 levels were found. There were no significant differences in CLT and PAI-1 levels. The fibrinolytic efficiency analysis showed that at T1 DD/TAT and DD/F1 + 2 ratios were lower in RF group and remained lower in RF than in CA group at T2. CA procedure may be associated with a lower degree of endothelial damage and with a higher fibrinolytic capacity respect to RF.

Original languageEnglish
Pages (from-to)853-860
Number of pages8
JournalInternal and Emergency Medicine
Volume9
Issue number8
DOIs
Publication statusPublished - Nov 22 2014

Keywords

  • Blood clotting activation
  • Cryoablation
  • Endothelial damage
  • Fibrinolysis
  • Platelet activation
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

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